Division of Cardiology, University of Cape Town, Cape Town, South Africa; Wits Donald Gordon Medical Centre, University of the Witwatersrand, Milpark Hospital, Johannesburg, South Africa. Email:
Division of Cardiology, University of Cape Town, Cape Town, South Africa.
Cardiovasc J Afr. 2021;32(1):28-32. doi: 10.5830/CVJA-2020-050. Epub 2020 Nov 12.
The aim was to assess the safety and efficacy of rotational atherectomy followed by drug-eluting balloon (DEB) in patients with a high risk of bleeding.
A retrospective review was carried out of hospital records of consecutive patients who underwent the hybrid procedure.
The average age of the 23 patients was 74 years. Risk factors for bleeding included renal failure (35%), oral anticoagulation use (26%) and peptic ulcer disease (35%). All patients had procedural success. No bleeding was reported over the 24-month follow-up period. Dual antiplatelet therapy was stopped successfully in six patients (26%) at three months. Two patients had confirmed target-lesion failure (restenosis). Two patients died over the study period but the cause of death was not known to be cardiovascular disease related.
For patients at high risk of bleeding who require rotablation, the use of a drug-eluting balloon may be a safe, effective alternative.
评估旋磨术联合药物洗脱球囊（DEB）治疗出血高危患者的安全性和有效性。
对连续接受杂交手术的患者的病历进行回顾性分析。
23 例患者的平均年龄为 74 岁。出血的危险因素包括肾衰竭（35%）、口服抗凝药物使用（26%）和消化性溃疡疾病（35%）。所有患者均手术成功。在 24 个月的随访期间，无出血报告。6 例患者（26%）在三个月时成功停用双联抗血小板治疗。2 例患者出现确认的靶病变失败（再狭窄）。研究期间有 2 例患者死亡，但死因未知与心血管疾病相关。
对于出血高危需要旋磨术的患者，使用药物洗脱球囊可能是一种安全、有效的替代方法。
